| NPI | 1245529767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX R1552) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000052519) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2020-06-11 |